Pharmaceutical Compositions Comprising Crystal Forms of 5-Azacytidine

ABSTRACT

The invention includes methods for isolating crystalline Form I of 5-azacytidine substantially free of other forms, wherein 5-azacytidine is represented by the formula: 
     
       
         
         
             
             
         
       
     
     The invention also includes pharmaceutical compositions comprising Form I of 5-azacytidine.

This application is a divisional of U.S. application Ser. No. 10/390,530, filed Mar. 17, 2003, entitled Methods For Isolating Crystalline Form I of 5-Azacytidine. The invention relates to the isolation of crystalline polymorphic Form I of 5-azacytidine (also known as azacitidine and 4-amino-1-β-D-ribofuranosyl-5-triazin-2(1H)-one). 5-azacytidine may be used in the treatment of disease, including the treatment of myelodysplastic syndromes (MDS).

BACKGROUND OF THE INVENTION Field of the Invention

Polymorphs exist as two or more crystalline phases that have different arrangements and/or different conformations of the molecule in a crystal lattice. When a solvent molecule(s) is contained within the crystal lattice the resulting crystal is called a pseudopolymorph, or solvate. If the solvent molecule(s) within the crystal structure is a water molecule, then the pseudopolymorph/solvate is called a hydrate. The polymorphic and pseudopolymorphic solids display different physical properties, including those due to packing, and various thermodynamic, spectroscopic, interfacial and mechanical properties (See H. Brittain, Polymorphism in Pharmaceutical Solids, Marcel Dekker, New York, N.Y., 1999, pp. 1-2). Polymorphic and pseudopolymorphic forms of the drug substance (also known as the “active pharmaceutical ingredient” (API)), as administered by itself or formulated as a drug product (also known as the final or finished dosage form, or as the pharmaceutical composition) are well known and may affect, for example, the solubility, stability, flowability, fractability, and compressibility of drug substances and the safety and efficacy of drug products, (see, e.g., Knapman, K Modern Drug Discoveries, March 2000: 53).

5-azacytidine (also known as azacitidine and 4-amino-1-13-D-ribofuranosyl-5-triazin-2(1H)-one; Nation Service Center designation NSC-102816; CAS Registry Number 320-67-2) has undergone NCI-sponsored trials for the treatment of myelodysplastic syndromes (MDS). See Kornblith et al., J. Clin. Oncol. 20(10): 2441-2452 (2002) and Silverman et al., J. Clin. Oncol. 20(10): 2429-2440 (2002). 5-azacytidine may be defined as having a formula of C₈H₁₂N₄O₅, a molecular weight of 244.20 and a structure of:

In the United States patent application entitled “Forms of 5-azacytidine,” Attorney Docket No. PHAR.02, filed Mar. 17, 2003 and incorporated herein by reference in its entirety, eight different polymorphic and pseudopolymorphic forms of 5-azacytidine (Forms I-VIII), in addition to an amorphous form, are described. Forms I-VIII each have characteristic X-Ray Powder Diffraction (XRPD) patterns and are easily distinguished from one another using XRPD.

5-azacytidine drug substance used in the previous clinical trials has typically been synthesized from 5-azacytosine and 1,2,3,5,-tetra-O-acetyl-β-D-ribofuranose by the method presented in Example 1. The last step of this method is a recrystallization of the crude synthesis product from a methanoUDMSO co-solvent system. Specifically, the crude synthesis product is dissolved in DMSO (preheated to about 90° C.), and then methanol is added to the DMSO solution. The product is collected by vacuum filtration and allowed to air dry.

In Attorney Docket No. PHAR.02 (supra), it is demonstrated that this prior art method for the recrystallization of the crude synthesis product does not control for the polymorphic forms of 5-azacytidine. Specifically, the prior art recrystallization procedure produces either Form I substantially free of other forms, or a Form I/II mixed phase i.e. a solid material in which 5-azacytidine is present in a mixed phase of both polymorphic Form I and polymorphic Form II. Thus, the prior art procedures do not allow one to reliably target Form I as the single polymorphic form in the drug substance. The present invention provides methods that allow one to recrystallize 5-azacytidine as polymorphic Form I robustly and reproducibly.

SUMMARY OF THE INVENTION

The present invention provides methods for robustly and reproducibly isolating 5-azacytidine as polymorphic Form I substantially free of other forms. The methods involve recrystallizing dissolved 5-azacytidine from a primary solvent/co-solvent mixture and then collecting the resultant crystals. The invention also provides pharmaceutical compositions comprising Form I of 5-azacytidine together with a pharmaceutically acceptable excipient, diluent, or carrier.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Polymorphic Form I of 5-azacytidine

Form I of 5-azacytidine is described fully in Attorney Docket No. PHAR.02 (see supra), and such descriptions are incorporated by reference herein. Table 1 provides the most prominent 20 angles, d-spacing and relative intensities for Form I observed using X-Ray Powder Diffraction (XRPD) performed according the method of Example 4:

TABLE 1 5-azacytidine Form I - the most prominent 2θ angles, d-spacing and relative intensities (Cu Kα radiation) 2θ Angle (°) d-spacing (Å) Relative Intensity 12.182 7.260 39.1 13.024 6.792 44.1 14.399 6.146 31.5 16.470 5.378 27.1 18.627 4.760 16.0 19.049 4.655 35.9 20.182 4.396 37.0 21.329 4.162 12.4 23.033 3.858 100.0 23.872 3.724 28.0 26.863 3.316 10.8 27.135 3.284 51.5 29.277 3.048 25.6 29.591 3.016 11.5 30.369 2.941 10.8 32.072 2.788 13.4

Isolation of Polymorphic Form I of 5-azacytidine by Recrystallization

Form I of 5-azacytidine may be reproducibly isolated substantially free of other forms by recrystallizing dissolved 5-azacytidine and collecting the resultant crystals. Specifically, 5-azacytidine is first dissolved completely in at least one suitable primary solvent, preferably a polar solvent, more preferably a polar aprotic solvent. Suitable polar aprotic solvents include, but are not limited to, dimethylformamide (DMF), dimethylacetamide (DMA), dimethylsulfoxide (DMSO), and N-methylpyrrolidinone (NMP). The most preferred polar aprotic solvent is DMSO. Mixtures of two or more primary solvents are also contemplated for dissolving the 5-azacytidine, for example a mixture of DMSO and DMF.

The 5-azacytidine used to form the solution may be synthesized by any procedure known in the art; an exemplary prior art synthesis scheme is provided in Example 1. Any polymorphic or pseudopolymorphic form(s) of 5-azacytidine, including mixed phases, may be used to form the solution. Amorphous 5-azacytidine may also be used to form the solution. It is preferred, but not required, that the primary solvent is preheated to an elevated temperature in order to ensure that the 5-azacytidine is dissolved completely. An especially preferred primary solvent is dimethyl sulfoxide, (DMSO), most preferably preheated to a temperature in the range of about 40° C. to about 90° C.

Following solvation of the 5-azacytidine in the primary solvent, at least one co-solvent is added to the solution of 5-azacytidine. Suitable co-solvents include C₂-C₅ alcohols (which term hereinafter refers to C₂-C₅ alcohols that are independently: branched or unbranched, substituted or unsubstituted), aliphatic ketones (which term hereinafter refers to aliphatic ketones that are independently: branched or unbranched, substituted or unsubstituted), and alkyl cyanides (which term hereinafter refers to alkyl cyanides that are independently: branched or unbranched, substituted or unsubstituted). Preferred C₂-C₅ alcohols, aliphatic ketones, and alkyl cyanides, along with other suitable solvents, are listed below as Class 2 (solvents to be limited) and Class 3 (solvents of low toxic potential) per the International Conference on Harmonization's (ICH) Guideline for Residual Solvents, July 1997). The use of mixtures of two or more of any of the aforementioned co-solvents is also included within the scope of the invention.

-   -   Class 2     -   Acetonitrile     -   Chlorobenzene     -   Cyclohexane     -   1,2-Dichloroethene     -   Dichloromethane     -   1,2-Dimethoxyethane     -   N,N-Dimethylformamide     -   N,N-Dimethylacetamide     -   1,4-Dioxane     -   2-Ethoxyethanol     -   Ethyleneglycol     -   Formamide     -   2-Methoxyethanol     -   Methylbutyl ketone     -   Methylcyclohexane     -   Nitromethane     -   Pyridine     -   Sulfolane     -   Tetralin     -   1,1,2-Trichloroethene     -   Class 3     -   1-Butanol     -   1-Pentanol     -   1-Propanol     -   2-Butano I     -   2-Methyl-1-propanol     -   2-Propanol (isopropyl alcohol)     -   3-Methyl-1-butanol     -   Acetone     -   Anisole     -   Butyl acetate     -   Cumene     -   Ethanol     -   Ethyl acetate     -   Ethyl ether     -   Ethyl Formate     -   Isobutyl acetate     -   Isopropyl acetate     -   Methyl acetate     -   Methylethyl ketone     -   Methylisobutyl ketone     -   Propyl acetate     -   tert-Butylmethyl ether     -   Tetrahydrofuran

It is preferred, but not required, that the co-solvents are preheated before mixing with the primary solvent, preferably to a temperature below the temperature at which a substantial portion of the co-solvent would boil, most preferably to about 50° C. It is also preferred, but not required, that the co-solvent(s) is added gradually to the primary solvent(s).

Following mixing, the primary solvent(s)/co-solvent(s) mixture is then equilibrated at different temperatures in order to promote either a slow recrystallization or a fast recrystallization of Form I of 5-azacytidine, as described below.

By slow recrystallization is meant that the co-solvent/DMSO solution is allowed to equilibrate at a temperature in the range from about 0° C. to about 40° C., preferably in the range of about 15° C. to about 30° C., and most preferably at about ambient temperature. Slow recrystallization of Form I of 5-azacytidine is preferably performed using C₂-C₅ alcohols, aliphatic ketones, or alkyl cyanides as the co-solvent. More preferably, slow recrystallization is performed with Class 3 C₂-C₅ alcohols, Class 3 aliphatic ketones, or acetonitrile (Class 2). The most preferred Class 3 C₂-C₅ alchohols are ethanol, isopropyl alcohol, and 1-propanol, and the most preferred Class 3 aliphatic ketone is methylethyl ketone.

By fast recrystallization is meant that the co-solvent solution is allowed to equilibrate at a temperature of below 0° C., preferably below about −10° C., and most preferably at about −20° C. Fast recrystallization of Form I of 5-azacytidine is preferably performed with a C₃-C₅ alcohol (which term hereinafter refers to C₃-C₅ alcohols which are independently: branched or unbranched, substituted or unsubstituted) or an alkyl cyanide as the co-solvent. More preferably the C₃-C₅ alcohol is a Class 3 solvent, and the alkyl cyanide is acetonitrile. The most preferred Class 3 C₃-C₅ alcohols are isopropyl alcohol (2-propanol) and 1-propanol.

Non-limiting examples of protocols for the recrystallization of Form I according to the methods described herein are provided in Examples 2 (slow recrystallization with DMSO as the primary solvent and ethanol, isopropyl alcohol, acetonitrile, or methylethyl ketone as the co-solvent) and 3 (fast recrystallization with DMSO as the primary solvent, and isopropyl alcohol or acetonitrile as the co-solvent) below.

Following recrystallization, the Form I of 5-azacytidine crystals may be isolated from the co-solvent mixture by any suitable method known in the art. Preferably, the Form I crystals are isolated using vacuum filtration through a suitable filter medium or by centrifugation.

Using the novel methods provided herein, it is possible for the first time to target Form I of 5-azacytidine as the drug substance reproducibly and robustly. In particular, isopropyl alcohol and acetonitrile reliably produce Form I independent of cooling rate (either slow recrystallization or fast recrystallization) and are preferred as the recrystallization co-solvents to recover Form I. Most preferably, Form I is isolated using isopropyl alcohol as the co-solvent since isopropyl alcohol carries a Class 3 risk classification (solvent of low toxic potential), whereas acetonitrile carries a Class 2 risk classification (solvent to be limited). The use of the DMSO/isopropyl alcohol system allows Form I of 5-azacytidine to be reliably recovered for the first time from solvents of low toxic potential without requiring control over the rate of recrystallation. In the most preferred embodiment, Form I of 5-azacytidine may be recovered simply by dissolving 5-azacytidine in DMSO (preferably heated to a temperature in the range of about 40° C. to about 90° C. prior to the addition of 5-azacytidine), adding isopropyl alcohol, and allowing the resulting solvent mixture to equilibrate at about ambient temperature.

In some embodiments of the invention, Form I of 5-azacytidine may be recovered from a primary solvent(s)/co-solvent(s) mixture by “seeding” with a small amount of Form I of 5-azacytidine either prior to, or during, the addition of the co-solvent(s). By seeding with Form I, it is possible to expand the list of suitable co-solvents and co-solvent classes beyond those listed above. For example, it is known that recrystallization from the DMSO/methanol system produces either Form I, or a Form I/II mixed phase (see Example 1). If a small amount of Form I is added to the solution of 5-azacytidine in DMSO prior to addition of the methanol co-solvent, or is added during the addition of the methanol co-solvent, then Form I of 5-azacytidine may be reliably isolated.

By allowing the isolation of a single polymorphic form, one skilled in the art will appreciate that the present invention allows for the first time the production of 5-azacytidine drug substance with uniform and consistent properties from batch to batch, which properties include but are not limited to solubility and dissolution rate. In turn, this allows one to provide 5-azacytidine drug product (see below) which also has uniform and consistent properties from batch to batch.

Pharmaceutical Formulations

For the most effective administration of drug substance of the present invention, it is preferred to prepare a pharmaceutical formulation (also known as the “drug product” or “pharmaceutical composition”) preferably in unit dose form, comprising one or more of the 5-azacytidine polymorphs of the present invention and one or more pharmaceutically acceptable carrier, diluent, or excipient. Most preferably, Form I 5-azacytidine prepared according to the methods provided herein is used to prepare the pharmaceutical formulation.

Such pharmaceutical formulation may, without being limited by the teachings set forth herein, include a solid form of the present invention which is blended with at least one pharmaceutically acceptable excipient, diluted by an excipient or enclosed within such a carrier that can be in the form of a capsule, sachet, tablet, buccal, lozenge, paper, or other container. When the excipient serves as a diluent, it may be a solid, semi-solid, or liquid material which acts as a vehicle, carrier, or medium for the 5-azacytidine polymorph(s). Thus, the formulations can be in the form of tablets, pills, powders, elixirs, suspensions, emulsions, solutions, syrups, capsules (such as, for example, soft and hard gelatin capsules), suppositories, sterile injectable solutions, and sterile packaged powders.

Examples of suitable excipients include, but are not limited to, starches, gum arabic, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, cellulose, water, syrup, and methyl cellulose. The formulations can additionally include lubricating agents such as, for example, talc, magnesium stearate and mineral oil; wetting agents; emulsifying and suspending agents; preserving agents such as methyl- and propyl-hydroxybenzoates; sweetening agents; or flavoring agents. Polyols, buffers, and inert fillers may also be used. Examples of polyols include, but are not limited to: mannitol, sorbitol, xylitol, sucrose, maltose, glucose, lactose, dextrose, and the like. Suitable buffers encompass, but are not limited to, phosphate, citrate, tartrate, succinate, and the like. Other inert fillers which may be used encompass those which are known in the art and are useful in the manufacture of various dosage forms. If desired, the solid pharmaceutical compositions may include other components such as bulling agents and/or granulating agents, and the like. The compositions of the invention can be formulated so as to provide quick, sustained, controlled, or delayed release of the drug substance after administration to the patient by employing procedures well known in the art.

In certain embodiments of the invention, the 5-azacytidine polymorph(s) may made into the form of dosage units for oral administration. The 5-azacytidine polymorph(s) may be mixed with a solid, pulverant carrier such as, for example, lactose, saccharose, sorbitol, mannitol, starch, amylopectin, cellulose derivatives or gelatin, as well as with an antifriction agent such as for example, magnesium stearate, calcium stearate, and polyethylene glycol waxes. The mixture is then pressed into tablets or filled into capsules. If coated tablets, capsules, or pulvules are desired, such tablets, capsules, or pulvules may be coated with a concentrated solution of sugar, which may contain gum arabic, gelatin, talc, titanium dioxide, or with a lacquer dissolved in the volatile organic solvent or mixture of solvents. To this coating, various dyes may be added in order to distinguish among tablets with different active compounds or with different amounts of the active compound present.

Soft gelatin capsules may be prepared in which capsules contain a mixture of the 5-azacytidine polymorph(s) and vegetable oil or non-aqueous, water miscible materials such as, for example, polyethylene glycol and the like. Hard gelatin capsules may contain granules or powder of the 5-azacytidine polymorph in combination with a solid, pulverulent carrier, such as, for example, lactose, saccharose, sorbitol, mannitol, potato starch, corn starch, amylopectin, cellulose derivatives, or gelatin.

Tablets for oral use are typically prepared in the following manner, although other techniques may be employed. The solid substances are gently ground or sieved to a desired particle size, and a binding agent is homogenized and suspended in a suitable solvent. The 5-azacytidine polymorph(s) and auxiliary agents are mixed with the binding agent solution. The resulting mixture is moistened to form a uniform suspension. The moistening typically causes the particles to aggregate slightly, and the resulting mass is gently pressed through a stainless steel sieve having a desired size. The layers of the mixture are then dried in controlled drying units for a pre-determined length of time to achieve a desired particle size and consistency. The granules of the dried mixture are gently sieved to remove any powder. To this mixture, disintegrating, anti-friction, and anti-adhesive agents are added. Finally, the mixture is pressed into tablets using a machine with the appropriate punches and dies to obtain the desired tablet size.

In the event that the above formulations are to be used for parenteral administration, such a formulation typically comprises sterile, aqueous and non-aqueous injection solutions comprising one or more 5-azacytidine polymorphs for which preparations are preferably isotonic with the blood of the intended recipient. These preparations may contain anti-oxidants, buffers, bacteriostats, and solute; which render the formulation isotonic with the blood of the intended recipient. Aqueous and non-aqueous suspensions may include suspending agents and thickening agents. The formulations may be present in unit-dose or multi-dose containers, for example, sealed ampules and vials. Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules, and tablets of the kind previously described.

Liquid preparations for oral administration are prepared in the form of solutions, syrups, or suspensions with the latter two forms containing, for example, 5-azacytidine polymorph(s), sugar, and a mixture of ethanol, water, glycerol, and propylene glycol. If desired, such liquid preparations contain coloring agents, flavoring agents, and saccharin. Thickening agents such as carboxymethylcellulose may also be used.

As such, the pharmaceutical formulations of the present invention are preferably prepared in a unit dosage form, each dosage unit containing from about 5 mg to about 200 mg, more usually about 100 mg of the 5-azacytidine polymorph(s). In liquid form, dosage unit contains from about 5 to about 200 mg, more usually about 100 mg of the 5-azacytidine polymorph(s). The term “unit dosage form” refers to physically discrete units suitable as unitary dosages for human subjects/patients or other mammals, each unit containing a predetermined quantity of the 5-azacytidine polymorph calculated to produce the desired therapeutic effect, in association with preferably, at least one pharmaceutically acceptable carrier, diluent, or excipient.

The following examples are provided for illustrative purposes only, and are not to be construed as limiting the scope of the claims in any way.

EXAMPLES Example 1 Prior Art Procedure for Synthesis and Recrystallization of 5-azacytidine Drug Substance

5-azacytidine may be synthesized using commercially available 5-azacytosine and 1,2,3,5-tetra-O-acetyl-β-D-ribofuranose (RTA) according to the following pathway:

The crude synthesis product is dissolved in DMSO (preheated to about 90° C.), and then methanol is added to the DMSO solution. The co-solvent mixture is equilibrated at approximately −20° C. to allow 5-azacytidine crystal formation. The product is collected by vacuum filtration and allowed to air dry.

Example 2 Form I of 5-azacytidine: Slow Recrystallization of 5-azacytidine from Co-Solvent Systems

Approximately 250 mg of 5-azacytidine was dissolved with approximately 5 ml of dimethyl sulfoxide (DMSO), preheated to approximately 90° C., in separate 100-mL beakers. The solids were allowed to dissolve to a clear solution. Approximately 45 mL of ethanol, isopropyl alcohol, acetonitrile, or methyl ethyl ketone co-solvent, preheated to approximately 50° C., was added to the solution and the resultant solution was mixed. The solution was covered and allowed to equilibrate at ambient conditions. The product was collected by vacuum filtration using a Buchner funnel.

Example 3 Form I of 5-azacytidine: Fast Recrystallization of 5-azacytidine from Co-Solvent Systems

Approximately 250 mg of 5-azacytidine was dissolved with approximately 5 mL of DMSO, preheated to approximately 90° C., in separate 100-ml beakers. The solids were allowed to dissolve to a clear solution. Approximately 45 mL of isopropyl alcohol or acetonitrile co-solvent, preheated to approximately 50° C., was added to the solution and the resultant solution was mixed. The solution was covered and placed in a freezer to equilibrate at approximately −20° C. to allow crystal formation. Solutions were removed from the freezer after crystal formation. The product was collected by vacuum filtration using a Buchner funnel.

Example 4 X-Ray Powder Diffraction of Recrystallized 5-azacvtidine

X-ray powder diffraction (XRPD) patterns for each sample were obtained on a Scintag XDS 2000 or a Scintag X₂ θ/θ diffractometer operating with copper radiation at 45 kV and 40 mA using a Kevex Psi Peltier-cooled silicon detector or a Thermo ARL Peltier-cooled solid state detector. Source slits of 2 or 4 mm and detector slits of 0.5 or 0.3 mm were used for data collection. Recrystallized material was gently milled for approximately one minute using an agate mortar and pestle. Samples were placed in a stainless steel or silicon sample holder and leveled using a glass microscope slide. Powder diffraction patterns of the samples were obtained from 2 to 42° 2θ at P/minute. Calibration of the X₂ diffractometer is verified annually using a silicon powder standard.

XRPD performed according to this method revealed that the Form I of 5-azacytidine was isolated in Example 2 by slow recrystallization using either ethanol, isopropyl alcohol, acetonitrile, or methyl ethyl ketone as the co-solvent, and in Example 3 by fast recrystallization using isopropyl alcohol or acetonitrile as the co-solvent. The results indicate that Form 1 of 5-azacytidine may be reliably recovered from the DMSO/isopropyl alcohol and DMSO/acetonitrile solvent systems without control of the rate of recrystallization. 

1-21. (canceled)
 22. A pharmaceutical composition for oral administration comprising Form I of 5-azacytidine substantially free of other forms of 5-azacytidine.
 23. The pharmaceutical composition of claim 22, which is in a single unit dosage form.
 24. The pharmaceutical composition of claim 23, which further comprises a carrier, diluent, or excipient.
 25. The pharmaceutical composition of claim 24, which comprises mannitol.
 26. The pharmaceutical composition of claim 24, which comprises microcrystalline cellulose.
 27. The pharmaceutical composition of claim 24, which comprises magnesium stearate.
 28. The pharmaceutical composition of claim 24, which is a tablet.
 29. The pharmaceutical composition of claim 22 or 24, which is a capsule.
 30. The pharmaceutical composition of claim 24, which contains between about 5 mg and about 200 mg of Form I of 5-azacytidine.
 31. The pharmaceutical composition of claim 30, which contains about 100 mg of Form I of 5-azacytidine.
 32. A pharmaceutical composition for oral administration comprising Form I of 5-azacytidine substantially free of other forms of 5-azacytidine, wherein the Form I of 5-azacytidine is prepared according to a method comprising: crystallizing 5-azacytidine from a solvent mixture comprising at least one polar aprotic solvent and at least one co-solvent, wherein the co-solvent is selected from: 1,1,2-trichloroethane, 1,2-dichloroethane, 1,2-dimethoxyethane, 1,4-dioxane, 1-butanol, 1-pentanol, 1-propanol, 2-butanol, 2-ethoxyethanol, 2-methoxyethanol, 2-methyl-1-propanol, 2-propanol (isopropyl alcohol), 3-methyl-1-butanol, acetone, acetonitrile, anisole, butyl acetate, chlorobenzene, cumene, cyclohexane, dichloromethane, ethanol, ethyl acetate, ethyl ether, ethyl formate, ethyleneglycol, formamide, isobutyl acetate, isopropyl acetate, methyl acetate, methylbutyl ketone, methylcyclohexane, methylethyl ketone, methylisobutyl ketone, N,N-dimethylacetamide, N,N-dimethylformamide, nitromethane, propyl acetate, pyridine, sulfolane, tert-butylmethyl ether, tetrahydrofuran, and tetralin; and isolating the Form I of 5-azacytidine.
 33. The pharmaceutical composition of claim 32, wherein the method further comprises heating the solvent mixture to dissolve the 5-azacytidine.
 34. The pharmaceutical composition of claim 32, wherein the method further comprises cooling the solvent mixture to allow crystal formation.
 35. The pharmaceutical composition of claim 32, wherein the method further comprises seeding with Form I of 5-azacytidine.
 36. The pharmaceutical composition of claim 32, wherein the co-solvent is acetonitrile.
 37. The pharmaceutical composition of claim 32, wherein the co-solvent is ethanol.
 38. The pharmaceutical composition of claim 32, wherein the co-solvent is methylethyl ketone.
 39. The pharmaceutical composition of claim 32, wherein the co-solvent is 2-propanol (isopropanol).
 40. The pharmaceutical composition of claim 32, wherein the co-solvent is 1-propanol.
 41. The pharmaceutical composition of claim 32, wherein the polar aprotic solvent is selected from: dimethylsulfoxide, dimethylformamide, dimethylacetamide, and N-methylpyrrolidinone.
 42. The pharmaceutical composition of claim 32, wherein the polar aprotic solvent is dimethylsulfoxide.
 43. The pharmaceutical composition of claim 32, which is in a unit dosage form.
 44. The pharmaceutical composition of claim 43, which further comprises a carrier, diluent, or excipient.
 45. The pharmaceutical composition of claim 44, which comprises mannitol.
 46. The pharmaceutical composition of claim 44, which comprises microcrystalline cellulose.
 47. The pharmaceutical composition of claim 44, which comprises magnesium stearate.
 48. The pharmaceutical composition of claim 44, which is a tablet.
 49. The pharmaceutical composition of claim 44, which is a capsule.
 50. The pharmaceutical composition of claim 44, which contains between about 5 mg and about 200 mg of Form I of 5-azacytidine.
 51. The pharmaceutical composition of claim 50, which contains about 100 mg of Form I of 5-azacytidine.
 52. A pharmaceutical composition for oral administration comprising Form I of 5-azacytidine substantially free of other forms of 5-azacytidine, wherein the Form I of 5-azacytidine is prepared according to a method comprising: dissolving 5-azacytidine in dimethyl sulfoxide solvent; seeding the dimethyl sulfoxide solution with Form I of 5-azacytidine; adding methanol co-solvent during or after the seeding; and isolating Form I of 5-azacytidine.
 53. The pharmaceutical composition of claim 52, which is in a unit dosage form.
 54. The pharmaceutical composition of claim 53, which further comprises a carrier, diluent, or excipient.
 55. The pharmaceutical composition of claim 54, which comprises mannitol.
 56. The pharmaceutical composition of claim 54, which comprises microcrystalline cellulose.
 57. The pharmaceutical composition of claim 54, which comprises magnesium stearate.
 58. The pharmaceutical composition of claim 54, which is a tablet.
 59. The pharmaceutical composition of claim 54, which is a capsule.
 60. The pharmaceutical composition of claim 54, which contains between about 5 mg and about 200 mg of Form I of 5-azacytidine.
 61. The pharmaceutical composition of claim 60, which contains about 100 mg of Form I of 5-azacytidine. 